AN ACT to amend and reenact §30-3-16 of the Code of West Virginia,
1931, as amended, relating to physician assistants; updating
language to conform to national changes; requiring supervising
physicians to be fully licensed without restriction or
limitation; permitting graduates of an approved program who
have passed the national certifying examination for physician
assistants to obtain temporary licenses; requiring a physician
assistant who fails a recertifying examination to immediately
notify the supervising physician and the board of Medicine and
immediately cease practice and requiring automatic license
expiration until passage of the examination; raising fees and
adding fees for temporary license and prescriptive writing
privileges.

Be it enacted by the Legislature of West Virginia:
That §30-3-16 of the Code of West Virginia, 1931, as amended,
be amended and reenacted to read as follows:ARTICLE 3. WEST VIRGINIA MEDICAL PRACTICE ACT.

(a) As used in this section:
(1) "Approved program" means an educational program for
physician assistants approved and accredited by the Committee on
Accreditation of Allied Health Education Programs or its successor;
(2) "Health care facility" means any licensed hospital,
nursing home, extended care facility, state health or mental
institution, clinic or physician's office;
(3) "Physician assistant" means an assistant to a physician
who is a graduate of an approved program of instruction in primary
health care or surgery, has attained a baccalaureate or master's
degree, has passed the national certification examination and is qualified to perform direct patient care services under the
supervision of a physician;
(4) "Physician assistant-midwife" means a physician assistant
who meets all qualifications set forth under subdivision (3) of
this subsection and fulfills the requirements set forth in
subsection (d) of this section, is subject to all provisions of
this section and assists in the management and care of a woman and
her infant during the prenatal, delivery and postnatal periods; and
(5) "Supervising physician" means a doctor or doctors of
medicine or podiatry permanently and fully licensed in this state
without restriction or limitation who assume legal and supervisory
responsibility for the work or training of any physician assistant
under his or her supervision.
(b) The board shall promulgate rules pursuant to the
provisions of article three, chapter twenty-nine-a of this code
governing the extent to which physician assistants may function in
this state. The rules shall provide that the physician assistant
is limited to the performance of those services for which he or she
is trained and that he or she performs only under the supervision
and control of a physician permanently licensed in this state, but
that supervision and control does not require the personal presence
of the supervising physician at the place or places where services
are rendered if the physician assistant's normal place of
employment is on the premises of the supervising physician. The
supervising physician may send the physician assistant off the premises to perform duties under his or her direction, but a
separate place of work for the physician assistant may not be
established. In promulgating the rules, the board shall allow the
physician assistant to perform those procedures and examinations
and in the case of certain authorized physician assistants to
prescribe at the direction of his or her supervising physician in
accordance with subsection (r) of this section those categories of
drugs submitted to it in the job description required by this
section. Certain authorized physician assistants may pronounce
death in accordance with the rules proposed by the board which
receive legislative approval. The board shall compile and publish
an annual report that includes a list of currently licensed
physician assistants and their supervising physician(s) and
location in the state.
(c) The board shall license as a physician assistant any
person who files an application together with a proposed job
description and furnishes satisfactory evidence to it that he or
she has met the following standards:
(1) Is a graduate of an approved program of instruction in
primary health care or surgery;
(2) Has passed the certifying examination for a primary care
physician assistant administered by the National Commission on
Certification of Physician Assistants and has maintained
certification by that commission so as to be currently certified;
(3) Is of good moral character; and
(4) Has attained a baccalaureate or master's degree.
(d) The board shall license as a physician assistant-midwife
any person who meets the standards set forth under subsection (c)
of this section and, in addition thereto, the following standards:
(1) Is a graduate of a school of midwifery accredited by the
American college of nurse-midwives;
(2) Has passed an examination approved by the board; and
(3) Practices midwifery under the supervision of a
board-certified obstetrician, gynecologist or a board-certified
family practice physician who routinely practices obstetrics.
(e) The board may license as a physician assistant any person
who files an application together with a proposed job description
and furnishes satisfactory evidence that he or she is of good moral
character and meets either of the following standards:
(1) He or she is a graduate of an approved program of
instruction in primary health care or surgery prior to the first
day of July, one thousand nine hundred ninety-four, and has passed
the certifying examination for a physician assistant administered
by the National Commission on Certification of Physician Assistants
and has maintained certification by that commission so as to be
currently certified; or
(2) He or she had been certified by the board as a physician
assistant then classified as "Type B" prior to the first day of
July, one thousand nine hundred eighty-three.
(f) Licensure of an assistant to a physician practicing the specialty of ophthalmology is permitted under this section:
Provided, That a physician assistant may not dispense a
prescription for a refraction.(g) When a graduate of an approved program who has
successfully passed the national commission on certification of
physician assistants' certifying examination submits an application
to the board for a physician assistant license, accompanied by a
job description as referenced by this section, and a fifty dollar
temporary license fee, and the application is complete, the board
shall issue to that applicant a temporary license allowing that
applicant to function as a physician assistant.
(h) When a graduate of an approved program submits an
application to the board for a physician assistant license,
accompanied by a job description as referenced by this section, and
a fifty dollar temporary license fee, and the application is
complete, the board shall issue to that applicant a temporary
license allowing that applicant to function as a physician
assistant until the applicant successfully passes the national
commission on certification of physician assistants' certifying
examination: Provided, That the applicant shall sit for and obtain
a passing score on the examination next offered following
graduation from the approved program.
(i) No applicant may receive a temporary license who,
following graduation from an approved program, has sat for and not
obtained a passing score on the examination.
(j) A physician assistant who has not been certified by the
national commission on certification of physician assistants will
be restricted to work under the direct supervision of the
supervising physician.
(k) A physician assistant who has been issued a temporary
license shall, within thirty days of receipt of written notice from
the national commission on certification of physician assistants of
his or her performance on the certifying examination, notify the
board in writing of his or her results. In the event of failure of
that examination, the temporary license shall expire and terminate
automatically and the board shall so notify the physician assistant
in writing.
(l) In the event that a physician assistant fails a
recertification examination of the National Commission on
Certification of Physician Assistants and is no longer certified,
the physician assistant shall immediately notify his or her
supervising physician or physicians and the board in writing. The
physician assistant shall immediately cease practicing, the license
shall expire and terminate automatically, and the physician
assistant is not eligible for reinstatement until he or she has
obtained a passing score on the examination.
(m) Any physician applying to the board to supervise a
physician assistant shall affirm that the range of medical services
set forth in the physician assistant's job description are
consistent with the skills and training of the supervising physician and the physician assistant. Before a physician
assistant can be employed or otherwise use his or her skills, the
supervising physician and the physician assistant must obtain
approval of the job description from the board. The board may
revoke or suspend any license of an assistant to a physician for
cause, after giving that assistant an opportunity to be heard in
the manner provided by article five, chapter twenty-nine-a of this
code and as set forth in rules duly adopted by the board.
(n) The supervising physician is responsible for observing,
directing and evaluating the work, records and practices of each
physician assistant performing under his or her supervision. He or
she shall notify the board in writing of any termination of his or
her supervisory relationship with a physician assistant within ten
days of the termination. The legal responsibility for any
physician assistant remains with the supervising physician at all
times, including occasions when the assistant under his or her
direction and supervision, aids in the care and treatment of a
patient in a health care facility. In his or her absence, a
supervising physician must designate an alternate supervising
physician, however, the legal responsibility remains with the
supervising physician at all times. A health care facility is not
legally responsible for the actions or omissions of the physician
assistant unless the physician assistant is an employee of the
facility.
(o) The acts or omissions of a physician assistant employed by health care facilities providing inpatient or outpatient services
shall be the legal responsibility of the facilities. Physician
assistants employed by facilities in staff positions shall be
supervised by a permanently licensed physician.
(p) A health care facility shall report in writing to the
board within sixty days after the completion of the facility's
formal disciplinary procedure, and also after the commencement, and
again after the conclusion, of any resulting legal action, the name
of any physician assistant practicing in the facility whose
privileges at the facility have been revoked, restricted, reduced
or terminated for any cause including resignation, together with
all pertinent information relating to the action. The health care
facility shall also report any other formal disciplinary action
taken against any physician assistant by the facility relating to
professional ethics, medical incompetence, medical malpractice,
moral turpitude or drug or alcohol abuse. Temporary suspension for
failure to maintain records on a timely basis or failure to attend
staff or section meetings need not be reported.
(q) When functioning as a physician assistant, the physician
assistant shall wear a name tag that identifies him or her as a
physician assistant. A two and one-half by three and one-half inch
card of identification shall be furnished by the board upon
licensure of the physician assistant.
(r) A physician assistant may write or sign prescriptions or
transmit prescriptions by word of mouth, telephone or other means of communication at the direction of his or her supervising
physician. A fee of fifty dollars will be charged for prescription
writing privileges. The board shall promulgate rules pursuant to
the provisions of article three, chapter twenty-nine-a of this code
governing the eligibility and extent to which a physician assistant
may prescribe at the direction of the supervising physician. The
rules shall include, but not be limited to, the following:
(1) Provisions for approving a state formulary classifying
pharmacologic categories of drugs that may be prescribed by a
physician assistant:
(A) The following categories of drugs shall be excluded from
the formulary: Schedules I and II of the Uniform Controlled
Substances Act, anticoagulants, antineoplastic,
radiopharmaceuticals, general anesthetics and radiographic contrast
materials;
(B) Drugs listed under Schedule III shall be limited to a
72-hour supply without refill; and
(C) Categories of other drugs may be excluded as determined by
the board.
(2) All pharmacological categories of drugs to be prescribed
by a physician assistant shall be listed in each job description
submitted to the board as required in subsection (i) of this
section;
(3) The maximum dosage a physician assistant may prescribe;
(4) A requirement that to be eligible for prescription privileges, a physician assistant shall have performed patient care
services for a minimum of two years immediately preceding the
submission to the board of the job description containing
prescription privileges and shall have successfully completed an
accredited course of instruction in clinical pharmacology approved
by the board; and
(5) A requirement that to maintain prescription privileges, a
physician assistant shall continue to maintain National
Certification as a Physician Assistant and, in meeting the national
certification requirements, shall complete a minimum of ten hours
of continuing education in rational drug therapy in each
certification period. Nothing in this subsection shall be
construed to permit a physician assistant to independently
prescribe or dispense drugs.
(s) A supervising physician may not supervise at any one time
more than three full-time physician assistants or their equivalent,
except that a physician may supervise up to four hospital-employed
physician assistants. No physician shall supervise more than four
physician assistants at any one time.
(t) A physician assistant may not sign any prescription,
except in the case of an authorized physician assistant at the
direction of his or her supervising physician in accordance with
the provisions of subsection (r) of this section. A physician
assistant may not perform any service that his or her supervising
physician is not qualified to perform. A physician assistant may not perform any service that is not included in his or her job
description and approved by the board as provided for in this
section.
(u) The provisions of this section do not authorize any
physician assistant to perform any specific function or duty
delegated by this code to those persons licensed as chiropractors,
dentists, dental hygienists, optometrists or pharmacists or
certified as nurse anesthetists.
(v) Each application for licensure submitted by a licensed
supervising physician under this section is to beaccompanied by a
fee of two hundred dollars. A fee of one hundred dollars is to be
charged for the biennial renewal of the license. A fee of fifty
dollars is to be charged for any change or addition of supervising
physician, or change or addition of job location. A fee of fifty
dollars will be charged for prescriptive writing privileges.
(w) As a condition of renewal of physician assistant license,
each physician assistant shall provide written documentation of
participation in and successful completion during the preceding
two-year period of continuing education, in the number of hours
specified by the board by rule, designated as Category I by the
American Medical Association, American Academy of Physician
Assistants or the Academy of Family Physicians and continuing
education, in the number of hours specified by the board by rule,
designated as Category II by the association or either academy.
(x) Notwithstanding any provision of this chapter to the contrary,failure to timely submit the required written
documentation shall result in the automatic expiration of any
license as a physician assistant until the written documentation is
submitted to and approved by the board.
(y) If a license is automatically expired and reinstatement is
sought within one year of the automatic expiration, the former
licensee shall:
(1) Provide certification with supporting written
documentation of the successful completion of the required
continuing education;
(2) Pay a renewal fee; and
(3) Pay a reinstatement fee equal to fifty percent of the
renewal fee.
(z) If a license is automatically expired and more than one
year has passed since the automatic expiration, the former licensee
shall:
(1) Apply for a new license;
(2) Provide certification with supporting written
documentation of the successful completion of the required
continuing education; and
(3) Pay such fees as determined by the board.
(aa) It is unlawful for any physician assistant to represent
to any person that he or she is a physician, surgeon or podiatrist.
Any person who violates the provisions of this subsection is guilty
of a felony and, upon conviction thereof, shall be imprisoned in a state correctional facility for not less than one nor more than two
years, or be fined not more than two thousand dollars, or both
fined and imprisoned.
(bb) All physician assistants holding valid certificates
issued by the board prior to the first day of July, one thousand
nine hundred ninety-two, shall be considered to be licensed under
this section.